Medical student perceived psychological safety in sensitive topic teaching: A qualitative study

Medical students are exposed to sensitive topics throughout their university education. Topics can be sensitive based on an individual's life experience, and common examples include domestic violence and mental health. Teaching sensitive topics risks re-traumatisation, and educators typically receive little training in balancing harm minimisation and maximising preparedness to handle distressing patient encounters. A trauma-informed medical education (TIME) approach has been proposed, aiming to optimise the learning environment, improve resilience and prepare students for practice. However, perceptions of TIME and which approaches students find effective remain incompletely understood.

We conducted a descriptive, qualitative study design using semi-structured interviews with sixteen medical students from Monash University, Australia. We recruited students in their final years who had completed their general practice rotation, and interviews were recorded and transcribed verbatim. We undertook reflexive thematic analysis of transcripts using NVivo software.

The overarching theme was the generation of a 'Safe Space' to learn sensitive topics. Contributing elements included sub-themes of (1) Preparedness for Teaching, (2) Teaching Techniques, and (3) Debriefing.

Students reported that many TIME strategies were already in place in their teaching. The findings highlighted that trauma-informed teaching strategies were effective in promoting medical student psychological safety and well-being.